Maternal marijuana use and neonatal outcome: uncertainty posed by self-reports.

Hingson, Ralph; Zuckerman, Barry; Amaro, Hortensia; Frank, Deborah A.; Kayne, Herbert L.; Sorenson, J R; Mitchell, Janet B.; Parker, Steven J.; Morelock, Suzette; Timperi, Ralph

doi:10.2105/ajph.76.6.667

Cited by 65 publications

(15 citation statements)

References 11 publications

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“…First, the data were derived from self-reports for which there was no objective validation. It can be argued that self-report measurement of substance use during pregnancy is subject to problems of poor instrument design, recall bias, and underreporting (19)(20)(21)(22). The issues involved in women's reluctance to reveal their substance use include the illicit nature of some substances, fear of having their children taken into care, fear of legal consequences, shame, guilt, and recall problems (23).…”

Section: Discussionmentioning

confidence: 99%

Birth outcomes associated with cannabis use before and during pregnancy

et al. 2011

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Articles Clinical Investigationnature publishing group INTRODUCTION:This study aimed to examine the association between cannabis use before and during pregnancy and birth outcomes. RESULTS: Overall, 26.3% of women reported previous use of cannabis and 2.6% reported current use. Multivariate analysis, controlling for potential confounders, including tobacco smoking, alcohol consumption, and use of other illicit drugs, showed that cannabis use in pregnancy was associated with low birth weight (odds ratio (OR) = 1.7; 95% confidence interval (cI): 1.3-2.2), preterm labor (OR = 1.5; 95% cI: 1.1-1.9), small for gestational age (OR = 2.2; 95% cI: 1.8-2.7), and admission to the neonatal intensive care unit (OR = 2.0; 95% cI: 1.7-2.4). DISCUSSION:The results of this study show that the use of cannabis in pregnancy is associated with increased risk of adverse birth outcomes. Prevention programs that address cannabis use during pregnancy are needed. METHODS: Data were from women birthing at the Mater Mothers' hospital in Brisbane, australia, over a 7-y period (2000)(2001)(2002)(2003)(2004)(2005)(2006). Women were interviewed in the initial antenatal visit about their use of cannabis and other substances. Records for 24,874 women who provided information about cannabis use, and for whom birth outcomes data were available, were included in the analysis.

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Section: Discussionmentioning

confidence: 99%

Birth outcomes associated with cannabis use before and during pregnancy

et al. 2011

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“…However, we identified 5 studies which determined the sensitivity of interview data on cannabis use among pregnant and postpartum women (Table 1). 20–24 These studies reported sensitivities ranging from 0.58 to 0.82. Because falsely reporting cannabis use is very unlikely, we assumed specificity to be 1.00 in all analyses.…”

Section: Methodsmentioning

confidence: 99%

Using Bayesian Models to Assess the Effects of Under‐reporting of Cannabis Use on the Association with Birth Defects, National Birth Defects Prevention Study, 1997–2005

Gelder

Donders

Devine

et al. 2014

Paediatric Perinatal Epid

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Background Studies on associations between periconceptional cannabis exposure and birth defects have mainly relied on self-reported exposure. Therefore, the results may be biased due to underreporting of the exposure. The aim of this study was to quantify the potential effects of this form of exposure misclassification. Methods Using multivariable logistic regression, we re-analyzed associations between periconceptional cannabis use and 20 specific birth defects using data from the National Birth Defects Prevention Study from 1997–2005 for 13 859 case infants and 6556 control infants. For seven birth defects, we implemented four Bayesian models based on various assumptions concerning the sensitivity of self-reported cannabis use to estimate odds ratios (ORs), adjusted for confounding and underreporting of the exposure. We used information on sensitivity of self-reported cannabis use from the literature for prior assumptions. Results The results unadjusted for underreporting of the exposure showed an association between cannabis use and anencephaly (posterior OR 1.9 [95% credible interval (CRI) 1.1, 3.2]) which persisted after adjustment for potential exposure misclassification. Initially, no statistically significant associations were observed between cannabis use and the other birth defect categories studied. Although adjustment for underreporting did not notably change these effect estimates, cannabis use was associated with esophageal atresia (posterior OR 1.7 [95% CRI 1.0, 2.9]), diaphragmatic hernia (posterior OR 1.8 [95% CRI 1.1, 3.0]) and gastroschisis (posterior OR 1.7 [95% CRI 1.2, 2.3]) after correction for exposure misclassification. Conclusions Underreporting of the exposure may have obscured some cannabis-birth defect associations in previous studies. However, the resulting bias is likely to be limited.

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“…These studies have shown improvements in self-reporting if participants are aware of potential laboratory confirmation. 117,118 However, these tests have lower sensitivity in women, especially in pregnant women, and no biomarkers are currently available that are sensitive enough to detect the relatively low levels of alcohol that would still place the fetus at risk. As with case definitions, consistent assessments and groupings of alcohol intake will be essential if data are to be compared between studies.…”

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confidence: 99%